Nosebleed in a 3 year old child. Nosebleed in a child. A trifle or a serious problem? Prevention of nosebleeds in children

One of the problems of childhood is nosebleeds. How to stop a nosebleed in a child, what can and cannot be done? How dangerous is this situation? When should you see a doctor?

Nosebleeds are known to be common in children. At a young age (from two to ten years), about 60% of children bleed from the nose.

Here's what parents should do if their child has a nosebleed:

Provide first aid. To do this, you need to know how to properly stop a nosebleed in a child.
If necessary, call an ambulance.
Find out the cause of the pathology.
Eliminate it according to the recommendations of a doctor or by performing general preventive measures.

Let's start with the first point.

In contact with

The sight of blood scares children, and some parents too. Therefore, to begin with, you should calm down, act without fuss and confidently.

Here's how to stop a nosebleed in a child at home:

Sit the teenager on a chair, and take the baby in your arms. Keep your head straight or tilt slightly forward.
Squeeze the wings of the nose with your fingers (or one nostril if the bleeding is one-sided). If there is a cloth or handkerchief nearby, use them. Breath goes through the mouth.
Keep your nose pinched for ten minutes. Then let go and see if the bleeding has stopped. If it still goes on, hold it down again and hold for another ten minutes. Before ten minutes, you should not release your nose. The resulting clot may break off and the bleeding will start again.
If the child is old enough to compress his nose on his own, then a cold compress is worth using. To do this, you can bring something from the freezer, wrap it in a cloth and put it on the bridge of your nose. Hold the compress for a maximum of ten minutes.
While the blood stops, you need to calm the child, talk to him. If possible, distract with an interesting toy, book, cartoons.

Need to reassure the child

When helping, it is important not to harm the child. You need to firmly learn what not to do:

Tilt your head back. In this case, the blood flows down the back of the throat, it is likely that it will enter the esophagus or larynx. This is bad for several reasons. First, it is difficult to estimate the amount of blood. Secondly, the child will experience nausea, vomiting may begin. And the most dangerous thing is that blood can get into the breathing tube and block the air supply to the lungs.
Blow your nose or pull blood clots out of your nostrils.
Put to bed. To stop bleeding, the head must be higher than the body.
Cough.
Insert dry cotton swabs into the nose. When removing a dry swab, the frozen crust comes off, and the blood will have to be stopped again.
Talk, move actively.

If a foreign object is stuck in the nose, you can not remove it yourself. Doing so can cause additional injury, cause severe bleeding, or inadvertently push an object down the throat. After the bleeding from the nose of the child has stopped, you should seek medical help.

If there is frequent nosebleeds, then what to do?

So the nosebleed has stopped. Well, if this is a one-time episode. But what if the nose bleeds constantly in a child? You need to undergo a medical examination, for which you should contact a pediatrician. The doctor will prescribe a general blood test, determine whether blood pressure is normal. If necessary, the child will be referred to a specialist, an x-ray or an MRI will be done. Based on the results of the examination, the doctor will issue recommendations and prescribe therapy.

In about 30% of cases, the cause of nosebleeds in children remains unknown.

If the child often bleeds from the nose, and the studies have not revealed anything, then follow the general recommendations. Here is what to do in such cases:

Control the level of humidity in the house or apartment. At low humidity, it is recommended to put a humidifier at least in the children's room.
Vasoconstrictive nasal drops should be used with caution and only on the recommendation of a pediatrician. For children under one year old, it is forbidden to use nasal drops with a vasoconstrictor effect.
Teach your child to pick their nose. If it has become a bad habit, take steps to eliminate it. Rinse your nose regularly with saline to prevent the formation of crusts.
Within a week after the bleeding episode, avoid physical activity.
In cold weather, cover your baby's nose with a scarf.
Introduce fresh fruits and vegetables in sufficient quantities into the children's diet.

Unfortunately, sometimes these measures do not help to completely avoid nosebleeds in children. It remains to wait for the vascular network to return to normal with age. Teach your child to cope with such troubles on their own.

What if it doesn't stop?

In 90% of cases, nosebleeds in children stop quickly. But you should be prepared for the fact that the blood from the nose of the child will not stop. What to do in this case?

Seek medical attention. They also call an ambulance if the victim has severe symptoms:

blood flows in a stream, without the formation of clots;
there is bleeding from other parts of the body;
the color of the blood is too bright, with a hint of scarlet;
blood with an impurity (foamy or coffee shade).

At the same time, even mild nosebleeds can be accompanied by common symptoms that do not require a visit to a doctor:

dizziness;
prostration;
increased sweating;
pale skin;
fainting state.

So what to do if a child has a nosebleed and does not stop? An important rule: if the bleeding could not be stopped within twenty minutes, an ambulance is called.

You may need to do a nasal packing

They call an ambulance even if there are dangerous signs and / or bleeding from the nose is accompanied by aggravating circumstances:

traumatic head injury;
severe bruising of the nose;
coughing up blood;
possible fracture of the bones of the skull;
vomiting with an admixture of blood;
fainting.

The presence of a complicating common disease in a child - diabetes mellitus, blood clotting disorders - is also a reason to seek emergency medical help.

How to quickly solve the problem?

There are several other ways to stop nosebleeds in a child. This is usually done if simply pinching the nose does not help.

For ten minutes, plug the nose with a cotton swab moistened with a 3% solution of hydrogen peroxide.
Drip five drops of a nasal remedy with a vasoconstrictor effect (galazolin, naphthyzinum) into each nostril. You can do this twice.

There are several ways to quickly stop a nosebleed in a child, and everyone chooses the most suitable for themselves.

In infants, the nasal mucosa and its vessels are still very fragile. At the slightest injury, light-colored blood comes out of the nose. The causes of nosebleeds in infants are the same as in older children.

Usually the problem is low humidity. Episodes of bleeding occur at night during sleep, when the baby is in a dry and warm room for a long time.

Ways to stop nosebleeds for a child under the age of one year are the same as for other children. The key point is the posture of the baby - you need to keep him upright and not allow blood to drain down the throat.

At the same time, nosebleeds in children under two years of age are quite rare. Frequent bleeding in infants should be alarming - this is a reason to visit a pediatrician.

There can be many reasons why blood flows from the nose. They are conditionally divided into groups.

The local reasons are:

contusions of the nose and head;
inflammation of the nose and neighboring organs (runny nose, acute respiratory infections, sinusitis);
damage to the mucous membrane of the nasal cavity;
recent surgery;
neoplasms in the nasal cavity.

Systemic causes:

fever;
internal bleeding;
change in hormonal status in puberty;
oncohematological diseases;
disorders in the work of the cardiovascular system, liver, kidneys.

This is how an anterior nosebleed occurs.

External factors:

abrupt climate change;
low air humidity;
a strong drop in atmospheric pressure;
the use of drugs - nasal drops, corticosteroids, non-steroidal anti-inflammatory drugs, anticoagulants;
extreme cold or heat;
overwork.

Sometimes a child's nose bleeds often after training. Here's what you need to do in this case: inform the coach, reduce the load. Perhaps it makes sense to take a short break in class.

In adolescence, rapid growth occurs, organ systems develop spasmodically, disproportionately. Sometimes the cardiovascular system does not keep up with the overall pace. Changes in the level of sex hormones affect the condition of the capillaries and the composition of the blood.

In adolescence, the emotionality of the child is increased. The number of stressful situations is increasing. In impressionable children, nosebleeds may begin with excitement.

If a teenager has a nosebleed, then in the vast majority this is due to the following points:

changes in blood pressure;
increased intracranial pressure;
in girls - the formation of the menstrual cycle.

Useful video

With nosebleeds, many almost reflexively throw their heads back, but, as indicated in the article, this should not be done. We offer 7 ways to help quickly deal with bleeding:

Conclusion

occur frequently in children.
Here's what to do if your child's nose bleeds: Tilt your head slightly forward and pinch your nostrils with your finger for ten minutes. In the vast majority of cases, this is enough to stop the bleeding.
If such episodes are repeated frequently, then it is necessary to identify the cause. To do this, you need to see a doctor and undergo a medical examination. Why an adult can bleed from the nose, find out.

Nosebleeds are no good. Especially if it happened to a child. In this case, most parents start to panic instead of helping the child. This happens because of not knowing the nature of epistaxis, its causes and algorithm of actions.

Why does a child's nose bleed?

Nosebleeds are divided into two types:

Front.
back.

They differ in that arterial blood during posterior bleeding moves along the wall of the nasopharynx and throat directly to the esophagus. Doctors rarely encounter this type of bleeding, unlike the anterior one, which goes through the nose.

But, despite the presence of blood, flowing in a small stream or dripping from the nose, the reasons for its appearance can be different:

Consequences of trauma.

Since the capillaries in the nasal cavity are very thin and located close to the mucosa, they are easily injured by any physical impact. At the same time, do not forget about the bad habit of children picking their nose. Since at the same time they also injure the walls of blood vessels and can provoke bleeding.

Chronic diseases.

Diseases such as chronic rhinitis, sinusitis and adenoids can provoke a local increase in pressure. At the same time, it will be difficult for the walls of the vessels to contain the blood in the channel.
Pathological conditions of the mucosa.

Any deviations in the state of the mucosa affect the walls of the vessels, which can become depleted and become brittle. Also, the presence of nosebleeds in a child can be affected by a deviated nasal septum, which is not a developmental norm. In this case, the development of capillaries is hindered, and blood flows out.

Tumors.

The most common tumors leading to bleeding are: malignancy, angioma, granuloma.

Chemical substances.

The nasal mucosa is extremely sensitive to any outside influences. At the same time, the mucous membrane of the child is even more sensitive to aggressive chemicals and can destroy thin vessels.

Avitaminosis.

The lack of vitamins is a direct cause of fragile vessels in children. Vitamin C is responsible for the elasticity of the walls, but the abuse of vitamins can have the opposite effect.
Violation of sanitary and hygienic standards of the premises.

Prolonged stay of children in a room with dry air dries out the wall and the capillaries in it.

Medicines.

Most nasal sprays, despite their therapeutic effect, injure the vessel wall, leading to bleeding.

However, any causes of bleeding are accompanied by the same symptoms that accompany the onset of the process. These symptoms are: ear congestion, dizziness, weakness. Therefore, knowing that the child suffers from frequent nosebleeds, you can warn him about the previous symptoms.

Nose bleeds in the morning

Epistaxis is not only chaotic in nature, but can also be strictly predictable. People, most of them children and adolescents, suffer from bleeding from the nasal cavity strictly in the morning, in other words, after sleep.

There are a great many reasons for this phenomenon, from those already mentioned above to strictly specific ones. Age-related changes can be an example of such specific bleeding. A young, growing organism can develop very quickly and some of its individual parts may not keep up with its growth. In this case, its capillaries are such a part. The amount of blood driven through them increases, and the walls still do not have time to gain the necessary strength. For the reason described above, they burst.

Overgrowth of tissues in the nasal mucosa and, as a result, squeezing of blood vessels can affect the appearance of bleeding. Not the last factor is a failure or change in the hormonal background of the body. The appearance of various changes associated with the work of hormones in conjunction with nasal hemorrhages often serve as a direct symptom of changes in hormones.

However, this example is purely individual and the cause of morning epistaxis is any congenital or acquired disease of both the nose and its structure, and the respiratory tract. Therefore, in the absence of visible reasons for such bleeding, it is necessary to seek help from a specialist. Only a doctor can determine the exact cause of nosebleeds in the morning.

How to stop the bleeding? First aid

Having studied the causes of the appearance of a scarlet liquid from the nose and realizing that they are not fatal, any person will be able to competently provide the first, urgent, help for bursting vessels in the wall of the nose, not only to an adult, but also to a child.

Of course, most people get lost at the sight of blood, and it takes some practice to give first aid without panic. In addition, bleeding can be of different strength, from weak to strong, in which a person loses blood in a matter of minutes. Complicating the task is that it is impossible to apply a tourniquet to the vessels of the head or stop the blood by pressing the vessel. In this case, only tamponade or stitching helps.

But, since we are talking about nosebleeds, only parietal capillaries can be injured here, the blood from which itself stops in a matter of minutes. Therefore, the measures taken to stop are extremely simple. Take a sterile swab (tightly rolled cotton wool) and insert it into the bleeding nostril. At the same time, it is necessary to plug the nostril completely throughout the entire nasal passage. It is advisable to plug the second one so that the blood does not go through it.

Just as important is the position of the head during this whole process. It should be held on an outstretched neck in front of you with your head slightly raised. It is worth paying attention that in no case should you throw your head back, as blood from the nose will flow down the larynx and into the digestive system, which can cause vomiting or malaise. Also, the child may choke on blood during inhalation.

Babies are bleeding from the nose

Any mother will protect her baby like the apple of her eye, and will worry at the slightest illness. Likewise, she cannot sit still knowing that her child had a nosebleed, even if it was a one-time occurrence. At the same time, in most cases, panic is unnecessary, and nosebleeds are not the result of painful or pathological phenomena.

All of the above causes of bleeding are applicable to the baby, but the most common of them is the dry air of the room during the heating season. This happens due to the fact that the baby's vessels in the nasal cavity are still too fragile and cannot withstand external stimuli. The first sign of this is dryness of the mucosa. By noticing such a warning sign in time, you can prevent the destruction of weak vessels by moistening the air in the room.

Humidify the air in several ways:

The easiest is to put 1-2 vessels of water in the child's room. More expensive is to buy a sprayer that will humidify the room at regular intervals.

However, there are cases when, after bleeding, you should immediately consult a doctor:
After an injury, blow to the nose or head, blood began to flow.

Perhaps the vessels burst not only on the nasal mucosa, so it is better to immediately go to the hospital.

Profuse nosebleed.

Do not forget that children have much less blood, so you need to soberly assess blood loss and contact specialists in case of a large hemorrhage.

After taking the medicine, there is bleeding.

Some drugs individually can cause nosebleeds. If this happens, you need to contact your doctor and change the course of treatment, as well as make a course of rehabilitation.

Against the background of epistaxis, the child's gums bleed, and bruises form.

This is the first sign of a complex problem of the body and blood-forming organs in particular. It can develop both against the background of beriberi, and more dangerous diseases. Such calls should not be ignored, you should immediately consult a doctor.

Measures to prevent bleeding are similar, as in previous situations with older children. However, do not forget that the baby can get scared while pressing the wings of the nose with a napkin. At this time, it is necessary to divert his attention with a toy so that he instinctively breathes through his mouth. At the same time, it is necessary to hold his head, not allowing it to be thrown back. Also, you can not let the child take a horizontal position, so that the blood does not enter the stomach and does not cause vomiting.

When is a doctor needed?

Most young mothers ask this question. They are interested in where is the line between one-time harmless bleeding and systematic, threatening the health of the child.

First of all, it must be said that an examination by a doctor will never be superfluous. In addition, such an examination will be able to identify diseases that are at an early stage of their development.

But such banal cases as minor physical injuries that caused bleeding and did not cause dizziness and nausea, may be ignored by the doctor. The same dryness in the room is felt by adults. Therefore, having solved the problem with air humidification, you can avoid going to the doctor, especially since he will advise you to solve this particular problem in the first place.

But there are cases when a visit to a doctor is necessary. All of them are described above and require the intervention of specialists, since only they can make a correct diagnosis, having the appropriate equipment and skills.

Treatment of nosebleeds in children

Treatment of nosebleeds is no less important than its prevention. The bleeding itself is capillary and goes away on its own in a few minutes, but some measures must be taken to save the vessels.
Sit the child upright and give the head a position, slightly raising the head in front. It is impossible to throw back the head so that the child does not choke on blood or it does not drain into the stomach and does not cause an attack of vomiting. Insert a swab throughout the entire nasal passage, preferably moistened with hydrogen peroxide or a vasoconstrictor spray. If bleeding continues for a long time (more than 8-10 minutes), you need to call an ambulance.

The ambulance carries out more effective and more radical measures to stop the bleeding. Also, an ambulance must be called if there is a foreign object in the nasal cavity or a head injury. Please note that you can not get a foreign object on your own, as it can block access to air.

Both doctors in the hospital and the ambulance use drugs for coagulation (cauterization of blood vessels). In some cases, hospitalization and placement in a hospital under close supervision may be required. Also, in the absence of positive dynamics, laser coagulation can be prescribed. For more serious vascular injuries, surgery is performed, during which the vessels are tied up.

In inpatient treatment, drugs are used that increase blood clotting, as well as vitamins that strengthen the walls of blood vessels. A hemostatic tube is used for the nasal cavity, which also stops the bleeding.

Prevention and treatment

Prevention is the best treatment, so any cause of bleeding should be prevented.

First of all, this requires:

Take special drugs that strengthen the walls of blood vessels.
Eat rationally.

This rule will help not only strengthen blood vessels, but also improve blood counts due to a balanced intake of micro and macro elements, as well as vitamins and minerals.
Regular airing of the premises and humidification of the air can prevent drying of the nasal mucosa wall and fragility of blood vessels. This is especially true for infants, this has already been written above.

Injury prevention.

Injuries are a direct cause of bleeding, and if infants can and should be protected from any injuries, then with running and frolicking children this is not so easy to do. However, a minor injury will not cause significant damage to health, unlike a more serious and severe one.

Mucosal protection for colds and allergies.

In most cases, a prolonged runny nose, caused by colds or allergies, also hardens the nasal wall, which becomes vulnerable to blood loss.

Also, parents themselves need to know all preventive measures, be periodically observed by an ENT doctor, know and be able to provide first aid.

In case of more serious and prolonged bleeding, an ambulance should be called. Further treatment will be prescribed by the attending physician in accordance with the current situation on an individual basis. The main methods of inpatient treatment have been described above, they are applied in any case.

ethnoscience

There are folk methods of stopping bleeding, as well as stopping regular bleeding. They can also be used at home to prevent hemorrhages:
Dilute a third of a tablespoon of alum and rinse the nose with the solution during bleeding, thus not only the bleeding will stop, but hemorrhages will stop over time. When bleeding, it is necessary to eat within two weeks before eating a leaf (2 cm long) of aloe arborescens. The action will be similar to washing with a solution of alum. In this case, it is necessary to raise the same-named hand during the hemorrhage, and clamp the nostrils with the opposite hand. During frequent epistaxis, take a small iron key and tie a woolen thread to it, then hang it around your neck. It is important to use a woolen thread and put on the key so that it is on the back between the shoulder blades. Also, traditional medicine recommends inserting cotton wool moistened with nettle juice (the juice must be fresh) into the nasal passages for 10-15 minutes and repeating the procedure the next day after bleeding. With very heavy bleeding, the patient can pour half a bucket of water on his head and the rest half a bucket on his back, this will also stop the bleeding. It helps to apply a cotton swab soaked in alcohol to the bridge of the nose for 10 minutes. After this procedure, bleeding usually disappears. Here you should be careful and close your eyes so that the alcohol does not get into the eye and burn it.

If blood flows from the nose of a child, the reasons can be very different, ranging from simple mechanical damage to the mucosa to severe hematological diseases. If you have this symptom, you should contact your pediatrician and undergo an examination.

Not everyone knows why a child is bleeding from the nose and why it is dangerous. Children of all ages face similar problems.

Epistaxis is a pathological condition characterized by the leakage of blood due to damage to blood vessels. In childhood, this occurs 4-5 times more often than in adults. There are the following causes of bleeding from the nose:

viral diseases (flu, measles, scarlet fever),
head tumors,
injury,
the bad habit of picking your nose with your fingers,
frequent insertion of tampons,
regular use of vasoconstrictor drugs,
hemophilia,
vasculitis,
systemic lupus erythematosus,
lack of platelets
blood clotting disorder
deviated septum of the nose,
breathing dry air
benign and malignant tumors,
hypovitaminosis,
hormonal changes during puberty,
hypertension,
increased intracranial pressure,
trauma during childbirth
congenital and acquired malformations,
gastrointestinal bleeding,
exposure to ionizing radiation,
severe atherosclerosis,
rise to great heights
pathology of the kidneys and liver,
heart disease.

Risk factors for developing this condition include poor nutrition, stress, exercise, changes in temperature and atmospheric pressure.

If a child's nose bleeds, prolonged exposure to the sun may be the cause. Dangerous and physical overload.

The state of blood vessels in children largely depends on external factors and the state of the body as a whole. Their fragility increases with a lack of any substances, with toxic effects or injury.

Mechanical damage to the nose

Children 10 years and older lead a very active lifestyle. At this age, trauma is the most common cause of bleeding. They are household, street, road.

Bleeding occurs as a result of a bruised nose, a fall, or a strong blow. This is possible under the following circumstances:

fights,
falling while running
falling from a height,
cycling.

Possible damage to blood vessels as a result of medical manipulations (catheterization, endoscopic examination, removal of polyps, sinus puncture). Injury often occurs when foreign objects hit. Children aged 4 years and younger like to put them in their noses. The most common injury is a bruise. It does not fracture.

Against the background of a bruise, the formation of a hematoma is possible. This is a cavity filled with blood.

Bleeding from the nose in children with a bruise is not the only symptom. There may be severe pain. Often, breathing is disturbed. With a fracture of the bones, the curvature of the nose in a child is visually determined. Isolated trauma is rare. Most often, the brain also suffers.

The reason for the lack of vitamins

A kid of any age needs good nutrition. The risk of bleeding increases with a lack of vitamins P and C in the body. This condition is called hypovitaminosis. The state of blood vessels depends on these substances. Vitamin P (rutin) is a flavonoid. It has the ability to reduce the permeability of blood vessels and strengthen their wall.

It is found in citrus fruits, rose hips, walnuts, cabbage, currants, chokeberry, buckwheat, lettuce, tomatoes. If a child rarely consumes these products, then a deficiency of the routine develops.

Hypovitaminosis can also be due to other causes (worm infestation, intoxication, antibiotics). Lack of routine is manifested by nosebleeds, hemorrhages, acne. Bruises often appear on the body of children. Often there is bleeding from the nose and gums.

Ascorbic acid is no less useful. The lack of this vitamin is due to a deficiency in the diet of fresh fruits, berries and vegetables. Hypovitaminosis is manifested by increased fragility of mainly small vessels (capillaries). Nosebleeds are observed in severe cases. Depending on age, the daily requirement for vitamin C is 30-90 mg.

Bleeding with high intracranial pressure

Rupture of small vessels in the nose is possible against the background of hypertension. Increased intracranial pressure is a common cause of bleeding in children. The following etiological factors are of greatest importance:

the inability of young children to blow their nose correctly,
the presence of neoplasms (hematomas, tumors),
abscesses
aneurysm,
edema on the background of encephalitis,
hepatic encephalopathy,
brain toxicity,
meningitis,
increased blood flow to the brain
hydrocephalus,
brain compression,
microcephaly,
congenital malformations,
birth trauma,
fetal infection.

Hypertension is manifested by periodic bleeding from the nose, headache, visual and oculomotor disorders, nausea, and vomiting.

Both the baby and the older child can get sick.

Most often, bleeding occurs against the background of congenital pathology. In chronic hypertension, periodic crises are observed, in which the pressure rises sharply.

Bleeding in chronic atrophic rhinitis

In children 11 years of age and older, the cause may lie in diseases of the nasal cavity. These include chronic atrophic rhinitis.

Teenagers are more commonly affected. Ozena is a type of atrophic rhinitis. In girls, this disease is detected much more often.

In children, this pathology is much less common than in adults.

From what rhinitis develops, only doctors know. The following causes of nosebleeds and atrophy of the nasal mucosa in children are distinguished:

injury,
severe infections,
diseases of the stomach, intestines and biliary tract,
surgical interventions,
performing radiation therapy,
genetic predisposition,
living in a dry, hot climate,
frequent colds,
uncontrolled use of nasal drops.

With a simple form of rhinitis, the symptoms are specific. These include intermittent bleeding, runny nose, nasal congestion, difficulty breathing, pale skin, child breathing through the mouth, crusting, itching in the nose, decreased sense of smell.

Rhinitis is focal and diffuse. The nose may bleed when you blow your nose. The reasons are thinning of the mucosa, its dryness and increased fragility of capillaries. The blood vessels in the nose are shallow.

Bleeding on the background of the tumor

There are serious diseases that lead to damage to blood vessels. The causes of nosebleeds in children include tumors. These can be angiofibromas and hemangiomas. This pathology often requires surgical treatment, otherwise bleeding can become permanent and lead to anemia. In children aged 5-12 years, angiomas are a common pathology.

These tumors account for up to 80% of all cases of congenital neoplasms. They form from dilated blood vessels. This pathology can be detected in a newborn. Symptoms are determined by the size of the neoplasm, its type and the age of the child. The tumor tends to grow.

If bleeding occurs, you should immediately go to the doctor.

Nosebleeds in children indicate the development of complications. This symptom is associated with the formation of ulcerative defects on the mucosa, their damage and infection. In case of injury to hemangiomas, emergency care may be needed.

Bleeding in hemophilia

In children aged 3-9 years and older, hemorrhages are often caused by diathesis. This is a group of pathological conditions caused by impaired hemostasis. In sick children, there is a tendency to constant hemorrhages and bleeding. There are about 300 diatheses.

The most common are those associated with leukemia, hemophilia, von Willebrand disease, disseminated intravascular coagulation, low platelets, and vascular defects.

Bleeding from the nose in childhood is a symptom of hemophilia. This is a hereditary disease characterized by a deficiency of a coagulation factor. The first symptoms appear in childhood.

The hereditary form of hemophilia develops only in boys. The acquired form of hemophilia, caused by gene mutation, is much less common. The age of children and the symptoms of the disease are interrelated.

Bleeding is caused by a violation of the formation of thromboplastin. This leads to a significant increase in clotting time. Massive blood loss can be fatal. It is known that a one-year-old child can already walk. This causes nosebleeds. At an earlier age, this symptom is absent.

In children aged 5-7 years, the manifestations of hemophilia are more pronounced. This disease is characterized by the following symptoms:

prolonged nosebleeds,
hematomas,
hemarthrosis (accumulation of blood in the joint cavity),
hematuria,
gastrointestinal bleeding.

The disease causes disability. Often, soft tissues are also involved in the process. On visual inspection, multiple bruises are visible on the skin. Sick children twelve years of age and older need lifelong replacement medications. There is no cure for hemophilia completely.

Leukemia as a cause of bleeding

In pediatric practice, a disease such as leukemia is common. This is blood cancer. The disease is detected among children and adults of different ages. The child may be one year old or ten years old.

This is a systemic disease that requires chemotherapy. The reason for the development of leukemia in children and bleeding is a change in the structure of chromosomes.

With this pathology, immature blood cells are formed in the bone marrow, which are not able to perform their functions. Girls get sick 1.5 times more often than boys.

This pathology is often detected in children with Down's disease and Klinefelter's syndrome. The acute form of leukemia is manifested by the following symptoms:

bleeding (nasal, stomach, intestinal, uterine),
signs of hypoxia of the body,
weakness
malaise,
enlargement of the liver, spleen and lymph nodes,
weight loss,
joint pain,
fever
petechiae on the body.

DIC and anemia often develop. In leukemia, hemolysis (destruction of red blood cells) occurs. The outflow of blood in cancer is possible from one nostril or from both at once. The development of hemorrhagic syndrome is based on hyperplasia of vascular cells, an increase in their permeability and impaired functioning of mast cells.

Bleeding in Werlhof's disease

With nosebleeds in children, the cause may lie in thrombocytopenic purpura. This is a type of hemorrhagic diathesis.

This pathology is otherwise called Werlhof's disease. Its development is based on a lack of platelets. The first signs of the disease are detected in children of early and preschool age. The baby may look healthy after birth. Diathesis appears later.

There are the following reasons for the development of this pathology:

taking medications (mercury drugs, hormones),
immunization,
viral diseases,
bacterial infections,
irradiation.

Children at the age of four have a wide variety of symptoms. Bleeding from the gums and nose are the most common signs of Werlhof's disease. They are very intense. Nosebleeds are combined with hematuria, impaired stool, vomiting, hemoptysis. Large blood loss leads to acute post-hemorrhagic iron deficiency anemia.

Altitude sickness and bleeding

Children are very sensitive to lack of oxygen. Nosebleeds are a common symptom of altitude sickness. This is a condition associated with oxygen starvation. The reason is being at a high altitude above sea level.

The higher, the lower the partial pressure of oxygen. Often this condition is observed in adolescents who are fond of hiking, flying on airplanes and hot air balloons.

Many older children over the age of 12 go camping with their parents. When climbing to a height of more than 2 km, symptoms of altitude sickness appear. One of them is nosebleeds. Its occurrence is due to the following changes in the body:

hypoxia
increased pressure in blood vessels,
venous stasis,
fluid retention,
increased capillary permeability,
a decrease in the osmotic pressure of the blood.

With mild mountain sickness, nosebleeds do not occur. With an average - they appear. Severe altitude sickness is characterized by severe bleeding from the nose, mouth, stomach, and lungs. The condition of these children is unsatisfactory. Along with bleeding, symptoms such as shortness of breath, palpitations, fatigue, weakness, non-productive cough, cyanosis of the skin, abdominal pain, flatulence, chills, and fever are observed.

When these complaints appear, you should consult a doctor. If the bleeding does not stop or occurs repeatedly, then a comprehensive examination is required. Blood clotting and the condition of vital organs are assessed.

Thus, nosebleeds occur not only in adults, but also in children. It may indicate a serious pathology.

Why does a child bleed from the nose at 2 years old? How to help the baby?

Blood in a child of 2 years old from the nose can go unexpectedly, at any time of the day. This is due to the fact that the nose in young children is still at the stage of development - the tissues are loose, easily injured, the nasal passage is narrow, the blood vessels penetrating the entire nasopharynx are thinner than in an adult. If bleeding has begun, it is necessary to stop it, and then look for the source of an unpleasant symptom.

The reasons

Blood from the nose of a child at night and during the day can go due to damage to small blood vessels. The baby can unsuccessfully roll over in a dream, hit the side of the crib, put a finger in his nose and touch the capillaries. It is necessary to ensure that the child does not pick his nose, and the crib has a soft surface and sides, carefully lay it down.

Other causes of damage to the nasal cavity:

Abnormal arrangement of capillaries - they are closer to the nostrils on the surface. With this, you can live in peace, the main thing is to observe certain security measures.
Thinning of the mucosa after prolonged use of drops that have a vasoconstrictive effect, for example, Naphthyzin, Xymelin.
deviated nasal septum;
Allergic rhinitis, chronic rhinitis.

Causes associated with diseases:

High blood pressure. Because of it, the capillaries burst, there is profuse bleeding.
Prolonged time in the sun. Children of this age are sensitive to the sun, so the duration of sunbathing should be limited. Heat stroke negatively affects the condition of the nasal cavity, bleeding opens.
Overwork, exercise. At two years old, the child is hyperactive, he is interested in everything. Parents often send their children to sports, but this age is fragile, make sure not to overload the child too much.
Neoplasms in the nose of a multidirectional nature. Papilloma, angioma, polyps - benign, treated with medication or surgery.
Acquired or congenital pathologies of the circulatory system. Among them, anemia, leukemia, lupus, vasculitis, hemophilia can occur.
Alien body. The second year of life in children is associated with curiosity, they can accidentally push a foreign object into the nostril. You should immediately go to the hospital with the child, the doctor will tell you what to do in this situation.
Infectious diseases affecting the upper respiratory tract, the entire body. In children at this age, measles, whooping cough, rubella, streptococcal infection, SARS, influenza, tonsillitis, sinusitis are more often noted.

Causes of heavy, regularly recurring bleeding, regardless of the time of day:

diseases of the kidneys, liver;
leukemia, tumors of a benign nature, malignant;
diseases of the gastrointestinal tract, cardiovascular system.

The reasons are very serious, so at the doctor's appointment, you need to talk about how the baby is worried about bleeding. Even if it seems to you that they arose due to local damage. The doctor will draw the appropriate conclusions, refer you for diagnostics or advise how to deal with it.

First aid: what to do and what not to do

It is advisable to call the doctor, and before his arrival try to stop the heavy bleeding. Small bruises should not be stopped. First, by studying them, the doctor will be able to draw a preliminary conclusion about the cause. Secondly, the doctor will be better able to stop minor bleeding.

How to stop bleeding incorrectly - typical mistakes:

Head thrown back. Blood begins to flow from the nasal cavity to the pharynx, the child swallows it unconsciously. The gastrointestinal tract reacts ambiguously - nausea appears, which can lead to vomiting. It is impossible to track whether the blood loss has stopped, what type it was.
Do not put a dry, untreated cotton ball in your nostrils. A cotton swab absorbs blood well, when it comes into contact with air, it dries up, sticks to the nasal septum, mucous membrane. When you remove the cotton wool, you can accidentally damage the capillaries, the mucous membrane, new bleeding will open. Non-sterile cotton wool can infect open wounds of the nasopharynx.

First aid rules:

Seat the child, tilt his head slightly down. Blood should flow freely from the nose, without entering the body through the esophagus.
Pinch the area just above the wings of the nose. Don't worry, baby will breathe through his nose. You can not remove your hands and check the condition until 10 minutes have passed. Such an effect compresses the vessels, prevents blood loss.
Cold. Take ice or something frozen from the freezer, wrap it in a towel, press it to the bridge of your nose. To enhance the effect, you can give cool water.
As soon as 10 minutes have elapsed, remove your hands from the crumbs' nose, make sure that the blood has stopped flowing, if this has not happened, repeat the previous points again.

Parents are not always in a hurry to call an ambulance, believing that the bleeding will pass with time - this is a big mistake.

There are signs that indicate that you cannot cope without medical help:

blood loss is too strong, poorly stopped;
blood comes from the nose is not the first time;
in addition to blood, the child has a headache, blood pressure and temperature rise;
severe pain in the abdomen, right or left hypochondrium is added;
if the cause was a bruise of the head, nose.

In this condition, you do not need to hesitate, call a doctor. He will help stop the bleeding and give the necessary recommendations.

Prevention

In order for the baby to successfully develop at both 2 and 3 years old, and not suffer from blood loss from the nose, care must be taken:

Humidity, purity. At least once every 2-3 days, carry out a thorough wet cleaning, ventilate the house, install a humidifier. The room should be 22 degrees and 50% humidity.
Hygiene. Rinse the nasal cavity with saline, oils, gradually accustom the baby to this.
Balanced diet. Although a child's diet is still very different from an adult's, make sure that it contains all the beneficial micronutrients, especially vitamin C.
Be careful when using vasoconstrictor drops.

Children are a joy, especially when they are healthy. If the child has started to bleed, be sure to pay attention to this. Go to the pediatrician, follow preventive measures.

Nosebleeds are a common pathology that often occurs in childhood. In most cases, the condition does not cause concern, but sometimes it is fraught with quite serious consequences.

Nosebleeds and its types in a child

Nasal blood loss is the outflow of blood fluid from the sinuses due to damage to the walls of blood vessels.

It is observed in 60% of children. Mostly unpleasant manifestations occur at the age of 2 to 10 years, the peak is from 3 to 8 years.

Often you can stop it yourself, using the simplest methods (cold, hydrogen peroxide). If the blood goes strongly, and this is repeated with enviable constancy, you should definitely pay attention, since pathology can lead to dangerous complications.

It is important to find out the cause of the appearance of an unpleasant symptom, since such a condition is caused by somatic or infectious diseases.

According to doctors, about 10% of patients who were taken to the hospital with severe nosebleeds are treated in the ENT departments.

Blood outflows are of two types:

anterior - comes from the front of the nose, usually on one side only. It accounts for about 90% of all nosebleeds. Localization occurs, as a rule, in the lower part of the septum. This area contains a large accumulation of small vessels that are easily injured. Often the nose bleeds due to the dry air in the room. As a result, dehydration of the mucosa occurs and cracks in the nasal membrane appear;
posterior - the most dangerous, because it appears due to a violation of the integrity of large vessels. The expiration occurs on the back wall of the throat. It is very difficult to stop the blood, so you should immediately call an ambulance. Occurs with increased pressure or in case of injury. It poses a great risk to the respiratory tract, as it can provoke aspiration and instant death.

Video - Emergency. "School of Dr. Komarovsky"

Causes of nosebleeds

Pathology occurs due to damage to the walls of blood vessels. Physicians distinguish local and general causes of the expiration.

trauma to the nose or head (fracture of the skull, nasal plate);
minor trauma to the mucous membranes (nose picking, insertion of small objects, scratching);
postoperative damage to the nasal septum (removal of adenoid tissue, puncture for sinusitis);
abnormal development of vascular tissue;
inflammatory diseases of the nasal mucosa (rhinitis, sinusitis, sinusitis);
inherited anomaly of the curvature of the septum;
neoplasms (tumors, polyps);
heavy physical activity (sports).

fragility of the vessels of the nose;
infectious diseases;
hereditary pathology;
dry air in the room;
lack of vitamin A, C;
hyperthermia of the body (overheating), solar "stroke";
increased body temperature;
cardiovascular diseases;
a jump in blood pressure in one direction or the other;
hormonal changes in the body in adolescents;
frequent use of vasoconstrictors and other drugs.

In most cases, bleeding appears due to a violation of the integrity of the vessels near the entrance to the nose. In this place is the Kisselbach zone, which is rich in capillaries. In addition, the mucous membrane here is more tender and fleshy than in other areas.

Children often have nosebleeds at night, which is very frightening for parents. If the unpleasant sign is one-time in nature, then you should not worry.

The main factor that could cause such a situation is nose picking and trauma to the mucous membrane. Another important reason may be too dry air in the room.

If blood loss is accompanied by complaints of headache and dizziness, the child should be taken for examination.

Video - Causes of nosebleeds and how to stop it properly

Features of treatment

Bleeding usually stops quickly and does not require medical intervention. However, sometimes the situation is out of control and it is not possible to stop the blood on its own. Doctors should be called urgently if the child has:

poor blood clotting (hemophilia);
loss of consciousness, fainting;
taking drugs that help thin the blood (aspirin-containing, ibuprofen);
there is a threat of a large loss of blood;
suspicion of a skull fracture (a clear liquid flows out with the blood);
there was vomiting with blood clots (possibly damage to the esophagus, ventricle) or outflow of blood with foam.

Children with renal hypertension, severe trauma to the head and nose, and impaired clotting are subject to emergency hospitalization.

First aid

In order to stop nosebleeds, it is necessary to carry out simple manipulations.

First of all, you should calm the baby and explain to him that nothing terrible has happened, there is no need to swallow blood.
The child is seated in a horizontal position. The body must be tilted slightly forward. If you tilt your head back, then the outflow of blood will only increase, and conditions will be created for it to enter the respiratory tract.
The nostrils are squeezed with fingers for 5-10 minutes, and cold is applied to the bridge of the nose.
After 5 min. swabs soaked in a 3% solution of hydrogen peroxide or vasoconstrictor drops (Nafthyzin, Galazolin) are carefully inserted into the nasal passages. The medicine is instilled in 2-3 drops and the nostrils are pressed.
Tampons should be removed very carefully, otherwise the clot will be damaged, and the bleeding will start again.
The mucous membranes of the nose are smeared with petroleum jelly or Neomycin (Bacitracin) ointment - this will speed up the healing process.

After the bleeding has stopped, the child should be taken to an ENT consultation to prevent recurrence. In addition, it is necessary to accurately identify the cause of nasal bleeding. The condition of the baby is assessed according to the results of rhinoscopy (a method for examining the sinuses using special mirrors). If necessary, the child is cauterized on the bleeding area. You may need to consult a hematologist, neuropathologist, endocrinologist and other specialists.

If the blood does not stop for more than 15–25 minutes, it is urgent to call an ambulance and hospitalize the baby.

What can not be done?

When nosebleeds are strictly prohibited:

Blow your nose as it causes increased flow.
Throwing the head back or laying the child on a horizontal surface - in this case, the veins in the head are compressed, the patient's blood pressure rises, which causes even more blood loss. In addition, blood fluid begins to flow down the back of the throat and can enter the stomach or respiratory tract. In this case, vomiting or blockage of the airways may occur, which is fraught with suffocation.
Self-extracting a foreign body from the sinuses - this can lead to the fact that it will move and cause suffocation.

Medications to treat nosebleeds

One of the effective methods of treatment is drug therapy. The doctor prescribes drugs that help reduce capillary fragility and permeability:

Askorutin (tablets), taken after meals;
Vitamin C;
Rutin.

Additionally, the doctor may prescribe:

Dicinon - used as a prophylaxis and to quickly stop bleeding. Can be taken as injections or tablets;
Aminocaproic acid - intravenously or in the form of drops;
Calcium chloride and calcium gluconate - intravenously;
Vikasol - used to enhance the effect of other drugs, as well as to improve blood clotting.

In case of severe bleeding that recurs periodically, the doctor may prescribe blood products:

platelet mass;
fresh frozen plasma.

If the outflow of blood occurred due to injury, the child is discharged;

Medicines for the treatment of nosebleeds - gallery

The dosage, frequency and duration of the use of drugs, as well as the form of application, are prescribed only by the attending physician after a thorough examination of the small patient and finding out the cause of the pathology.

The use of drug treatment can improve the situation within 7-10 days.

If the conservative treatment does not work, the doctor may resort to other methods of treatment.

Preventive measures

To prevent nosebleeds, a number of preventive measures should be taken to help strengthen the vessels:

air humidification in the room;
taking vitamin supplements;
the use of fresh vegetables, fruits, fish, dairy products, citrus fruits;
prevention of injuries of the nose and head;
avoid eating foods that can thin the blood: apples, tomatoes, cucumbers, strawberries, currants;
taking drugs that can strengthen the child's immunity and moisturize the nasal mucosa (especially in children who are prone to allergies and frequent colds).

The child should avoid heavy sports, as well as serious stress (especially after blood loss).

Preventive measures - gallery

Nosebleeds in childhood are often harmless. However, with abundant outflows, as well as relapses, you should consult a doctor for a thorough examination and identify the cause of the pathology. In any case, contacting specialists will not hurt, since this unpleasant syndrome can be a messenger of a serious illness.

The most frequent of the bleeding that occurs spontaneously is nasal. They often occur in children of different ages. The reason for hospitalization in the ENT hospital in 10-15 percent of cases is precisely this problem.

Types of nosebleeds in children

Bleeding from the nose can be from the back or front. In the first case, the causes are usually trauma, high blood pressure, or some serious illness. Bleeding from the anterior parts of the nasopharynx is not so dangerous, as it usually occurs when a vessel located on the septum is damaged.

Causes of sudden bleeding

In almost 90 percent of cases, the cause of nosebleeds in children is bursting vessels in the anterior sections. Vascular plexuses located superficially in the septum are easily damaged. Also, bleeding can be associated with the influence of several negative factors:

excessive dryness of some parts of the nasal mucosa (the mucosa loses its elasticity, strength, may be damaged by minor exposure);
very hot and dry air in the room (as a result, the mucous membrane dries up);
inhalation of tobacco smoke, dust, small particles of animal hair (also irritating to the nasal mucosa);
the formation of mucus and the fragility of blood vessels on the septum (it can be both a consequence of the action of irritants and caused by various health disorders);
pressure drops, for example when climbing mountains or flying in an airplane;
a high temperature in a child can also provoke bleeding;
hormonal changes that occur during adolescence;
too much physical stress or strong emotional experiences, stress (provoke an increase in blood pressure).

Often there is bleeding due to trauma (and it can be of a different nature and strength) or a foreign body entering the nose. In the first case, both nose picking and bone fracture can provoke the appearance of blood. Even if the child blows his nose too hard, hemorrhage may open. As for the second option, children, and especially small ones, can stick some object up their nose, which is not always immediately known to parents. Allocations in this case appear with pus, have an unpleasant odor.

These are the most common causes of bleeding and are relatively easy to fix. But frequent nosebleeds in a child can also occur as a result of other more dangerous conditions, health disorders. In this case, you will definitely need to consult a doctor so that the specialist makes an accurate diagnosis and prescribes the appropriate treatment. The following causes of frequent nosebleeds in children can lead to:

Various blood diseases. For example, hemophilia is a congenital disease that is characterized by a complete absence or a significant violation of blood clotting.
Increased vascular permeability as a result of an inflammatory process (for example, with vasculitis) or with serious illnesses (measles, influenza, and so on), some hereditary diseases, vitamin C hypovitaminosis (lack of ascorbic acid).
Chronic pathologies that disrupt the liver (cirrhosis or hepatitis, for example).
Chronic diseases of the paranasal sinuses or nasal cavity, which are of an inflammatory nature.
Various conditions that are accompanied by an increase in blood pressure. This can be physical exertion, renal hypertension, sunstroke, or general overheating of the body).
A change in the structure of the mucous membrane caused by various infections (for example, syphilis, diphtheria or tuberculosis) or chronic rhinitis.
Different kinds of benign and malignant tumors in the nasal cavity. For children, as a rule, neoplasms of a benign nature are characteristic.

In addition, the causes of nosebleeds in children can be determined by the anatomical features of the structure of the nasal septum, anomalies in the development of the vascular system of the nose, and curvature of the nasal septum. In the latter case, there is also difficulty in breathing.

The opinion of Dr. Evgeny Olegovich Komarovsky

The pediatrician of the highest category and the host of the program "School of Dr. Komarovsky", whose opinion is trusted by many parents, also spoke about nosebleeds in children. Komarovsky notes that the tendency to nosebleeds is often determined precisely by the anatomical features of the structure of the mucous membranes, in particular, the depth of the vessels and their diameter.

Blood can come from both the anterior and posterior sections of the nose. According to Evgeny Olegovich, the vast majority of manifestations of this symptom in childhood are caused by damage to a vessel located in the nasal septum. This is bleeding from the front of the nose. Options when blood comes from the posterior sections are relatively rare in childhood, but always dangerous. In this case, Komarovsky calls the cause of nosebleeds in children the manifestation of serious diseases of the internal organs, which are accompanied by disorders of the blood coagulation system and vascular damage.

Here is the most convenient symptom to help parents determine if nosebleeds are dangerous: Posterior bleeding is almost always from both nostrils, anterior bleeding is usually from one. Frequent nosebleeds in a child is definitely a reason to contact a specialist as soon as possible for examination, diagnosis and adequate treatment.

First aid

How to stop nosebleeds in a child? It is necessary to take actions that are aimed at stopping the symptom as soon as possible. Help with nosebleeds in a child should be provided immediately. Here is a brief algorithm of actions for parents:

Reassure the child, because the stress of seeing blood may cause high blood pressure and heart rate, which will only increase bleeding. The child and others need to be convinced that nothing terrible is happening, there is no danger to life, and the bleeding itself will soon stop. Parents need to stay calm and not panic.
Sit the child in such a way that the back is straight, the head is slightly lowered down, and the body is slightly tilted forward. Then gently squeeze the wings of the baby's nose with your fingertips, in other words, squeeze the nose. Stay in this position for at least ten minutes. It is not necessary to remove your fingers every thirty to fifty seconds, checking whether the blood is flowing or has already stopped.
During these ten minutes, while the parent holds the child's nose pinched, something cold can be applied to the bridge of the nose. Suitable, for example, an ice cube, a spoon, a coin or frozen vegetables. It is helpful to give the child something cold to drink or eat (eg ice cream, a glass of ice water through a straw), as the cold in the mouth will effectively stop nosebleeds.

Adult mistakes in helping

How to stop nosebleeds in a child? Practice shows that most parents, faced with such a problem, get lost and make mistakes. Here are some mistakes adults can make when helping children with nosebleeds:

You can't tilt your head back. In this case, the blood will not flow out of the nose, but will flow inward along the back wall of the nasopharynx. So it becomes impossible to determine how intense the bleeding is, whether it has stopped or not yet, and the baby may suffocate if there is too much blood.
No need to stuff cotton wool, a corner of a handkerchief, a tampon or other "plugs" into the nose. So, instead of flowing out, the blood will soak the cotton wool, thicken, gradually dry up to the nose along with the “plug”. Once the parents remove the cotton, the bleeding may start again.
You can not put the child in a prone position. With severe bleeding, vomiting may begin with an admixture of blood, which in this position almost always leads to the fact that the child chokes. It is best, as already mentioned above, to put the child on a chair or slightly tilt his body forward.
With severe bleeding from the nose, you do not need to provoke the child to talk or move. In most cases, this will only exacerbate the problem. But of course, it is necessary to calm the baby during first aid.

In what cases you need to call a doctor

Nosebleeds in children are usually not too serious and quickly correctable problem, but there are situations when qualified medical care is vital. This is true for the following circumstances:

The bleeding did not stop within twenty minutes. It is necessary to repeat the procedure for providing assistance (for another ten minutes, pinch the wings of the child's nose with your fingers). If after that the blood from the nose is still flowing, then it is urgent to call the doctors.
Intense bleeding from the nose, which comes from both nostrils at once. As a rule, this is caused by more serious reasons than minor mechanical damage to the mucosa.
Nosebleed is aggravated by any other bleeding. If at the same time there is blood from the ear, for example, then you need to urgently call the doctors.
Nosebleeds are regular. If the problem recurs every day, once every two or three days, once a week and the like, then it is imperative to show the child to a pediatrician.

With such nosebleeds in children, the need to visit a doctor is fully justified, since this symptom may indicate some kind of dangerous disease, and not just be the result of a burst vessel.

Also, an ambulance should be called if the child has blood mixed with a clear liquid (especially after a head injury) or foams, he loses consciousness, vomiting with blood appears. The help of qualified doctors is necessary for bleeding in children with diabetes mellitus, hemophilia or other blood diseases, as well as if the problem arose while taking Ibuprofen, Indomethacin, Aspirin, Heparin and other similar drugs that worsen clotting properties blood.

Coagulation of burst vessels with laser or nitrogen

Nosebleeds in children in the hospital are stopped by coagulation. Cauterization of a burst vessel with a laser, electricity or liquid nitrogen is carried out if the blood comes from the front of the nose. Indications for coagulation (electrocoagulation) are frequent bleeding, the ineffectiveness of attempts to stop the blood in another way, very heavy bleeding, and anemia due to relapses.

Treatment of bleeding from the back of the nose

Treatment of nosebleeds in children is also carried out with the use of hemostatic drugs. These methods are used if the blood comes from the back of the nose. Vikasol or sodium etamsylate are prescribed. If the blood loss is plentiful, then solutions are administered intravenously, and, if necessary, components of the donor's blood are transfused.

If there is a foreign object in the nose, then it is pulled out. In rare cases, it is necessary to use surgical methods, such as ligation or embolization of a bleeding vessel. The hospital also conducts a complete medical examination to determine the cause of the bleeding.

Therapy and prevention of frequent nosebleeds

Causes and treatment of nosebleeds in children are interrelated. So, if the problem occurs frequently, doctors may suspect a disease associated with impaired blood clotting processes. In this case, you will need special treatment for the cause of bleeding.

If the blood is due to mechanical damage, that is, trauma or a foreign body entering the nose, then you need to act according to the situation. Much depends on the severity of the injury (for example, a head injury that causes nosebleeds usually requires additional treatment). In case of damage caused by an insignificant mechanical effect, there is no need to prescribe hemostatic drugs.

For therapeutic and prophylactic purposes, calcium preparations, retinol, aka vitamin A (used in the form of an oily solution for instillation into the nose), "Askorutin" are prescribed. For children with nosebleeds, the dosage of Ascorutin is shown as follows: one tablet three times a day. The course of therapy is ten days. "Ascorutin" is not prescribed for children with nosebleeds with the following diagnoses:

diabetes;
kidney failure;
urolithiasis disease;
increased blood clotting;
individual sensitivity to the components of the drug;
thrombophlebitis;
fructose intolerance.

Some traditional medicine recipes

There are several alternative medicine recipes that can help reduce the incidence of nosebleeds in a child:

bury the juice of yarrow leaves in the nose;
take half a glass of bedstraw decoction three times a day, the decoction is prepared from two tablespoons of dry grass, pour half a liter of water, boil for ten minutes, and then insist for an hour;
take one tablespoon of viburnum bark decoction three times a day, before meals, for cooking, pour four tablespoons of crushed bark with one glass of water and boil for thirty minutes, and then strain and dilute with boiled water to the initial amount of liquid;
drink a tablespoon of nettle decoction four times a day, the decoction is prepared from a tablespoon of nettle leaves, which must be poured with a glass of water, boiled for ten minutes, and then cooled and strained.

How to prevent nosebleeds

To prevent the problem from recurring, you need to walk with the child in the fresh air more often, play outdoor games, saturate the diet with fresh vegetables and fruits according to the season, and additionally give the baby vitamins prescribed by the doctor. It is necessary to humidify and ventilate the room in which the child is constantly located as often as possible.

Nosebleeds in a child: causes and treatment

Nosebleeds in children always scare both parents and the kids themselves. So, nosebleeds can be the result of both a simple wound on the nasal mucosa, and indicate more serious health problems.

What happened to the child, what is the cause of bleeding, how to help? Many are lost, not knowing what to do, how to provide first aid. To properly behave in such a situation, read the proposed article.

Types of nosebleeds

There are two types of nosebleeds: anterior and posterior. The first type (anterior) is the most common and accounts for about 90% of all nosebleeds. It is characterized by a calm flow of blood when the vessels in the front of the nose are damaged. The second type (posterior) is much less common - in 10% of all cases. Such bleeding occurs due to damage to larger and deeper vessels, while the blood drains intensively along the back of the pharynx. It is more difficult to stop, it is more abundant, and therefore it is advisable to urgently seek qualified medical help without trying to cope with it yourself.

Not far from the nasal entrance, in the anterior part of the nasal septum, there is a small Kisselbach zone (the size of a penny coin). It is rich in blood vessels, its mucosa is looser and thinner than in other areas. Therefore, it is very easy to break the membrane and cause nosebleeds in this particular area of the vascular plexus. This is what happens in most cases.

Causes of nosebleeds

The direct cause of any bleeding is one - rupture of a blood vessel. But what provoked him, you need to figure it out as soon as the child is given first aid.

Common causes can occur under various conditions:

The fragility of the vascular walls, when the vessels are easily damaged as a result of the slightest stress in them:

infectious diseases that occur against the background of high temperature (chickenpox, measles, scarlet fever, rubella, whooping cough, influenza, meningococcal meningitis, tuberculosis, etc.);
vasculitis (non-infectious inflammation of the walls of blood vessels);
Osler-Rendu-Weber disease (hereditary pathology, a type of hemorrhagic diathesis, characterized by underdevelopment of the walls of blood vessels);
lack of vitamins, especially ascorbic acid and vitamin K, as well as calcium.

An increase in blood pressure at which a rupture of the capillary wall occurs:

physical and emotional overload;
adrenal tumors;
emphysema and pneumosclerosis;
chronic kidney disease - glomerulonephritis and pyelonephritis;
aortic and mitral stenosis (heart defects);
some other congenital heart defects;
atherosclerosis;
hypertonic disease.

Blood diseases:

disorders in the mechanism of blood clotting, for example, with hemophilia, coagulopathy, hemorrhagic diathesis;
leukemia or aplastic anemia;
Werlhof's disease (thrombocytopenic purpura) - a decrease in the number of platelets in the blood;
cirrhosis of the liver and other chronic diseases that affect blood clotting;
agranulocytosis (decrease in the number or complete absence of leukocytes in the blood).

Other reasons:

migraines and nervous disorders;
severe coughing and sneezing (contribute to a sharp increase in pressure in the vessels of the nose, because of which they can burst);
systemic lupus erythematosus (hereditary disease resulting from failures in the immune system);
changes in the hormonal background during adolescence in girls, during which there is an increased production of the sex hormones estrogen and progesterone;
dry air in the room, when the nasal mucosa dries up, atrophies, and the vessels become brittle;
sun or heat stroke (they are usually accompanied by tinnitus, weakness and dizziness);
frequent tamponade of the nasal cavity, as a result of which atrophy of the mucous membrane develops, and as a result, bleeding begins;
taking certain medications - vasoconstrictor nasal drops, antihistamines, corticosteroids, Heparin, Aspirin.

Rare causes of nosebleeds in children include:

exposure to radiation;
chemical, thermal and electrical burns of the nasal mucosa;
chronic intoxication of the body with harmful vapors and gases contained in aerosols and various chemicals;
changes in barometric pressure, such as when climbing or swimming at depth.

Sometimes nosebleeds are mistaken for bleeding from the esophagus, stomach, and lungs, when blood leaks out through the nose and mouth.

Nosebleeds practically do not require diagnosis, unlike the causes that caused it.

In addition to the signs of the underlying disease, several symptoms can be distinguished:

flowing from the nose of pure scarlet blood;
ringing or noise in the ears;
dizziness;
flashing flies before the eyes;
shortness of breath, rapid breathing;
heartbeat;
discomfort in the nose;
headache;
thirst;
general weakness.

When bleeding from the back of the nose, hemoptysis and vomiting of scarlet blood may occur.

Nosebleeds are usually one-sided, but in severe cases, the blood can fill the entire nostril and pass into the other. In this case, it will flow from both nostrils, even if the vessel is damaged only on one side.

Diagnostics

Only a pediatric ENT doctor can determine the type of bleeding using rhinoscopy and pharyngoscopy. After stopping the bleeding, you should begin to search for the causes, that is, fully examine the child:

take blood tests;
consult a pediatrician and pediatric specialists (hematologist, endocrinologist, cardiologist, immunologist, oncologist).

Complications

With heavy nosebleeds, hemorrhagic shock may develop:

a sharp decrease in blood pressure as a result of large blood loss;
confusion or loss of consciousness;
tachycardia;
severe pallor of the skin;
weak thready pulse.

For an objective assessment of the child's condition after blood loss, it is necessary to do a general blood test and a coagulogram.

Frequent nosebleeds can lead to serious consequences:

general depletion of the body;
development of anemia;
decrease in immunity.

Chronic oxygen starvation in the case of nosebleeds leads to disruption of the activity of various organs, as well as to the development of irreversible pathological changes in their structure.

If such health problems are ignored, death is possible.

Helping a child with a nosebleed

Anterior nosebleeds stop almost immediately and almost spontaneously. But still, some manipulations are required:

calm the child, seat him on a chair, and pick up the smallest ones;
unfasten clothes, try to make the child breathe in through the nose, and exhale through the mouth;
feet should be warm;
tilt your head slightly forward and pinch your nostrils with your fingers;
tilt your head back, but at the same time be sure to put a cold on the bridge of your nose and insert a swab into your nose;
put cold on the back of the head;
make a small tampon from cotton wool or bandage, moisten it in a 3% hydrogen peroxide solution or in vasoconstrictor drops and insert it into the nostril;
if there is no hydrogen peroxide, drip vasoconstrictor drops into the nose - Galazolin, Naphthyzin, Rinazolin or 0.1% adrenaline solution;
if bleeding continues, then after 10-15 minutes you need to call an ambulance.

As soon as the bleeding stops, the tampon cannot be pulled out sharply: this way you can damage the clot, and the blood will flow again. It is best to moisten it with hydrogen peroxide, and then remove it.

Then, twice a day, lubricate the nasal mucosa with petroleum jelly (or Neomycin, Bacitracin ointment) to prevent it from drying out again and promote better healing, which can last from 1 to 5 weeks.

When the air in the apartment is dry, especially during the heating season, it is recommended that the child instill in the nose products based on sea water - Salin or Aquamaris.

After stopping the bleeding of the child, it is necessary to show the ENT doctor to prevent recurrence. He will examine the baby, if necessary, he will cauterize the bleeding area, and if necessary, he will send him for a full examination to find out the reasons.

When bleeding, you can not:

blow your nose, this will displace the clot that forms, and the blood will flow again;
tilt your head back, as blood will drain down the back of the throat, enter the stomach or block the airways; in the first case, vomiting may occur, and in the second, suffocation;
if the cause of bleeding is a foreign body, it cannot be removed on its own, as it can move and cause suffocation.

Indications for calling an ambulance:

bleeding does not stop within 15-20 minutes;
there was a head injury, after which blood from the nose goes along with a clear liquid (suspicion of a fracture of the base of the skull);
intense bleeding, blood flows out in a stream, a clot does not form;
there is hemoptysis (back bleeding) or vomiting of blood (bleeding from the esophagus);
frothy blood (pulmonary bleeding);
in addition to bleeding, there is vomiting of the color of coffee grounds, which indicates gastric bleeding;
the child (teenager) often has high blood pressure;
a child whose nose bleeds is suffering from diabetes;
the baby had a faint;
a small patient receives drugs that reduce blood clotting - Aspirin, Indomethacin, Ibuprofen, Heparin, etc .;
the child is sick with hemophilia or other diseases with a violation of the mechanism of blood clotting.

Medical assistance

To stop intense nosebleeds, an ENT doctor can take the following measures:

anterior or posterior tamponade impregnated with a 1% solution of feracryl, preserved amnion, epsilon-aminocaproic acid;
remove a foreign body or polyps if they appear and cause nosebleeds;
the introduction of a swab with trichloroacetic acid or vagotil, which cauterize the vessels, thus stopping the bleeding;
coagulation (cauterization) of the bleeding area of the mucosa in one of the following ways: laser, ultrasound, electric current, liquid nitrogen, silver nitrate, chromic acid;
use of a hemostatic sponge in the nasal cavity;
with abundant blood loss - transfusion of donor blood, fresh frozen plasma, intravenous administration of rheopolyglucin, hemodez and aminocaproic acid;
if the measures provided are ineffective, surgical intervention is indicated - ligation or embolization (blockage) of large vessels that supply blood to the problem area of the nasal mucosa;
endoscopic cryodestruction;
the introduction of sclerosing drugs, an oil solution of vitamin A;
the appointment of drugs that increase blood clotting - calcium chloride, Vikasol, ascorbic acid, calcium gluconate.

In case of intensive bleeding or massive blood loss, hospitalization of the child in the ENT department is mandatory.

After a nosebleed, children should not play sports for several days, as well as consume hot drinks or meals. This causes a rush of blood and lymph to the head, which can again provoke bleeding.

Prevention

Prevention of nosebleeds should be carried out based on the causes that cause them. General measures include:

the use of Askorutin, which strengthens the walls of blood vessels;
good nutrition, the inclusion in the diet of vegetables, fruits, cereals, meat, fish; eating food rich in vitamins and minerals;
air humidification, regular check and cleaning of the air conditioner;
injury prevention;
the use of drugs that help moisturize the nasal mucosa, especially in children suffering from frequent colds and allergies.

Summary for parents

In order not to be confused at the time of the occurrence of nosebleeds in a child, one should study well the methodology of the necessary first aid, as well as constantly carry out preventive measures to strengthen the vascular wall in a child.

Which doctor to contact

With nosebleeds that do not stop within 15 minutes, you need to call an ambulance, which most often, after first aid, transports the child to a surgical hospital, where he is examined by an ENT doctor. If bleeding is regular, you need to contact a pediatrician and systematically examine the child with the involvement of the necessary specialized specialists: hematologist, neurologist, rheumatologist, endocrinologist, oncologist, infectious disease specialist, cardiologist, hepatologist.